NBCA胶联合弹簧圈超选择肾动脉栓塞治疗经皮肾镜术后出血的临床观察研究

Clinical study of NBCA glue combined with spring coil ultra-selective renal arteryembolization for the treatment of postoperative bleeding after percutaneousnephrolithotomy

目的 观察氰基丙烯酸正丁酯(n-butyl-cyanoacrylate,NBCA)胶联合弹簧圈采用微导管超选择肾动脉栓塞治疗经皮肾镜术肾出血的有效性及安全性。方法 选取2017年6月至2021年10月在平湖市第一人民医院行肾动脉栓塞治疗经皮肾镜取石后肾出血的20例患者,术中使用栓塞材料为NBCA胶或弹簧圈+NBCA胶,观察治疗后止血效果。结果 20例患者中有14例为肾假性动脉瘤患者,均采用弹簧圈+NBCA-碘化油混合比例(1:3)行栓塞。5例造影剂外溢的患者中,有4例使用弹簧圈+NBCA-碘化油混合比例(1:3)栓塞,1例患者为小动脉出血,直接用NBCA-碘化油混合比例(1:2)进行栓塞。20例患者经栓塞治疗后均取得满意效果,随访结果显示栓塞无再次肾出血及血尿症状发生。结论 NBCA胶联合弹簧圈采用微导管超选肾动脉栓塞治疗经皮肾镜取石导致肾出血安全、有效。

Objective To observe the efficacy and safety of n-butyl-cyanoacrylate(NBCA)adhesive combined with spring coil ultra-selective renal artery embolization for the treatment of postoperative bleeding after percutaneous nephrolithotomy.Methods A total of 20 patients who underwent renal artery embolization for treatment of postoperative bleeding after percutaneous nephrolithotomy were selected from June 2017 to October 2021 in Pinghu First People’s Hospital,and the embolization materials used during the operation were NBCA glue or spring coil+NBCA glue,to observe the effect of haemostasis after treatment.Results Fourteen case of 20 patient with renal arteriovenous fistula,using spring coils+NBCAiodized oil mixing ratio(1:3)embolism,and 5 cases of contrast extravasation patients,including 4 cases were embolized by using spring coil+NBCA-iodized oil mixing ratio(1:3),1 cases of bleeding in patients with small arteries,the direct use of iodized oil NBCA-mixing ratio(1:2)embolism.All 20 patients achieved satisfactory results after embolization,and there was no recurrence of renal bleeding or hematuria symptoms after embolization.Conclusion NBCA glue combined with spring coil is safe,effective and treatment of renal hemorrhage after percutaneous nephrolithotom.